scholarly journals Use of Incident Command System for Disaster Preparedness: A Model for an Emergency Department COVID-19 Response

2020 ◽  
pp. 1-6 ◽  
Author(s):  
Andra Farcas ◽  
Justine Ko ◽  
Jennifer Chan ◽  
Sanjeev Malik ◽  
Lisa Nono ◽  
...  
Keyword(s):  
Emergency Department ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Large Scale ◽  
Disaster Plan ◽  
Incident Command System ◽  
Incident Command ◽  
Optimal Coordination ◽  
Multiple Challenges ◽  
Operations Center

ABSTRACT The COVID-19 pandemic has placed unprecedented demands on health systems, where hospitals have become overwhelmed with patients amidst limited resources. Disaster response and resource allocation during such crises present multiple challenges. A breakdown in communication and organization can lead to unnecessary disruptions and adverse events. The Federal Emergency Management Agency (FEMA) promotes the use of an incident command system (ICS) model during large-scale disasters, and we hope that an institutional disaster plan and ICS will help to mitigate these lapses. In this article, we describe the alignment of an emergency department (ED) specific Forward Command structure with the hospital ICS and address the challenges specific to the ED. Key components of this ICS include a hospital-wide incident command or Joint Operations Center (JOC) and an ED Forward Command. This type of structure leads to a shared mental model with division of responsibilities that allows institutional adaptations to changing environments and maintenance of specific roles for optimal coordination and communication. We present this as a model that can be applied to other hospital EDs around the country to help structure the response to the COVID-19 pandemic while remaining generalizable to other disaster situations.

Y2K Medical Disaster Preparedness in New York City: Confidence of Emergency Department Directors in their Ability to Respond

2001 ◽  
Vol 16 (2) ◽  
pp. 88-95 ◽  
Author(s):  
Steven H. Silber ◽  
Neill Oster ◽  
Bonnie Simmons ◽  
Christopher Garrett
Keyword(s):  
Emergency Department ◽  
New York ◽  
New York City ◽  
York City ◽  
Disaster Preparedness ◽  
Large Scale ◽  
Disaster Plan ◽  
Incident Command ◽  
Additional Information ◽  
Department Directors

AbstractObjectives:To study the preparedness New York City for large scale medical disasters using the Year 2000 (Y2K) New Years Eve weekend as a model.Methods:Surveys were sent to the directors of 51 of the 9-1-1-receiving hospitals in New York City before and after the Y2K weekend. Inquiries were made regarding hospital activities, contingencies, protocols, and confidence levels in the ability to manage critical incidents, including weapons of mass destruction (WMD) events. Additional information was collected from New York City governmental agencies regarding their coordination and preparedness.Results:The pre-Y2K survey identified that 97.8% had contingencies for loss of essential services, 87.0% instituted their disaster plan in advance, 90.0% utilized an Incident Command System, and 73.9% had a live, mock Y2K drill. Potential terrorism influenced Y2K preparedness in 84.8%. The post-Y2K survey indicated that the threat of terrorism influenced future preparedness in 73.3%; 73.3% had specific protocols for chemical; 62.2% for biological events; 51.1% were not or only slightly confident in their ability to manage any potential WMD incidents; and 62.2% felt very or moderately confident in their ability to manage victims of a chemical event, but only 35.6% felt similarly about victims of a biological incident. Moreover, 80% felt there should be government standards for hospital preparedness for events involving WMD, and 84% felt there should be government standards for personal protective and DECON equipment. In addition, 82.2% would require a moderate to significant amount of funding to effect the standards. Citywide disaster management was coordinated through the Mayor's Office of Emergency Management.Conclusions:Although hospitals were on a heightened state of alert, emergency department directors were not confident in their ability to evaluate and manage victims of WMD incidents, especially biological exposures. The New York City experience is an example for the rest of the nation to underscore the need for further training and education of preparedness plans for WMD events. Federally supported education and training is available and is essential to improve the response to WMD threats.

scholarly journals Beyond ICS: How Should We Govern Complex Disasters in the United States?

2019 ◽  
Vol 16 (2) ◽  
Author(s):  
Branda Nowell ◽  
Toddi Steelman
Keyword(s):  
Disaster Response ◽  
Large Scale ◽  
National Policy ◽  
The United States ◽  
Network Governance ◽  
Governance Structures ◽  
Incident Command System ◽  
Incident Command ◽  
Complex Disasters ◽  
Private Actors

Abstract The complexity of large-scale disasters requires governance structures that can integrate numerous responders quickly under often chaotic conditions. Complex disasters – by definition – span multiple jurisdictions and activate numerous response functions carried out by numerous legally autonomous public, nonprofit, and private actors. The command operating structure of the Incident Command System (ICS) is a hierarchical structure used to manage complex incidents. Increasingly, complex disasters are seen as networks of multiple actors. Improving our capacity to respond to large-scale, complex disasters requires moving beyond the “hierarchy versus networks” debate to understand the conditions under which governance structures can best serve disaster response goals. Understanding the capabilities and limitations of the governance structures embedded in our national policy tools and frameworks can enhance our ability to govern effectively in networked contexts. In this article, we suggest the need to shift focus to build greater capacity for hybrid and network governance approaches, including a more sophisticated understanding of the conditions under which these governance forms are most effective.

Disaster Preparedness

1985 ◽  
Vol 1 (S1) ◽  
pp. 118-121 ◽  
Author(s):  
E. L. Quarantelli
Keyword(s):  
United States ◽  
Natural Disasters ◽  
Emergency Medical Service ◽  
Disaster Preparedness ◽  
Large Scale ◽  
Medical Service ◽  
The United States ◽  
Mass Casualties ◽  
Disaster Plan ◽  
Emergency Medical

The 1973 Emergency Medical Services System Act in the United States mandates that one of the 15 functions to be performed by every EMS system is coordinated disaster planning. Implicit in the legislation is the assumption that everyday emergency medical service (EMS) systems will be the basis for the provisions of EMS in extraordinary mass emergencies, or in the language of the act, during “mass casualties, natural disasters or national emergencies.” Policy interpretations of the Act specified that the EMS system must have links to local, regional and state disaster plans and must participate in biannual disaster plan exercises. Thus, the newly established EMS systems have been faced with both planning for, as well as providing services in large-scale disasters.

scholarly journals Assessment of the Staff of an Emergency Department Training in the Hospital Emergency Incident Command System

2001 ◽  
Vol 16 (S1) ◽  
pp. S61-S61
Author(s):  
Gürkan Ersoy ◽  
Ridvan Atilla ◽  
Sülen Sarioglu ◽  
Dilek Güldal ◽  
Eyüp Sabri Ucan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Emergency ◽  
Incident Command System ◽  
Incident Command

Disaster Management: An Introduction to the Incident Command System (ICS)

1986 ◽  
Vol 2 (1-4) ◽  
pp. 145-148
Author(s):  
Ronald L. D'Acchioli
Keyword(s):  
Resource Management ◽  
Disaster Management ◽  
Large Scale ◽  
Emergency Services ◽  
Daily Basis ◽  
The State ◽  
Incident Command System ◽  
Incident Command ◽  
Valuable Lesson ◽  
Management Scheme

SUMMARYThe Incident Command System is a personnel and resource management scheme which has several interactive components which make it an effective plan.This system is being used effectively in the State of California for the control of large scale incidents on a daily basis. Dr. Rodney Herbert of London advised us not long ago, during his presentation of the “Moorgate Incident”, an event in which he participated, that a valuable lesson was learned as that catastrophe unfolded and was managed by local emergency services agencies. The lesson learned was that “special plans” for disaster management which sit on a shelf to collect dust while awaiting the event soon become of little use through inactivity. His message was that the protocols used by emergency services agencies for disaster management should merely be an extension of the day-to-day activities of that agency.

scholarly journals Incident Command in the Time of COVID-19

2020 ◽  
Vol 51 (6) ◽  
pp. e78-e82
Author(s):  
Jim Cook
Keyword(s):  
Large Scale ◽  
Previous Experience ◽  
Incident Command System ◽  
Incident Command ◽  
Effective Manner ◽  
The Future ◽  
Core Functionality

Abstract The SARS-CoV-2 virus was initially contained in China but rapidly spread across the globe. The grave threat was not apparent until it was already in our midst. Our organization implemented an Incident Command System (ICS), based on previous experience, to respond to the COVID-19 pandemic in a comprehensive and effective manner. This well-known management and response framework is used by many specialties and organizations in disasters of different complexity and size. Our ICS was able to assemble the appropriate people, assess the situation, and develop and implement plans to deal with the COVID-19 crisis. The effectiveness of the ICS structure and its execution was instrumental in getting in front of the virus and managing regional activities. The ICS is an effective tool to improve safety and mitigate risk when dealing with large-scale disasters and should be implemented and practiced before the need arises. Our organization implemented a formal Incident Command System (ICS) very early as a response to the COVID-19 pandemic. Although it recently disbanded, we are maintaining its core functionality and communication as we continue to deal with COVID-19 into the future. The author has observed the ICS being used at hospitals through hurricanes, blizzards, and riots but never saw it work as well as it did during the initial weeks of the pandemic. This group deftly navigated through uncharted waters by leveraging the spirit and structure of Incident Command.

Coordination of Multiple States and Federal Agencies

2019 ◽  
pp. 281-294
Author(s):  
Timothy Jones ◽  
Craig Hedberg
Keyword(s):  
Management System ◽  
Large Scale ◽  
Pharmaceutical Products ◽  
Federal Agencies ◽  
Public Communication ◽  
Government Agencies ◽  
Sensitive Information ◽  
Incident Command System ◽  
Incident Command ◽  
Contaminated Food

Although most outbreaks are confined to a local jurisdiction, the number of multijurisdictional outbreaks (i.e., involving multiple geographic areas, widely distributed contaminated food or pharmaceutical products, or multiple government agencies) is increasing. In such cases, a clear and effective management system for the response must be established promptly. The roles and expectations of all involved responders should be clearly defined and closely monitored. Partners should be in regular communication throughout the response. Procedures and mechanisms for sharing of appropriate data and protecting sensitive information should be established from the onset of the investigation. Public communication about the investigation and response should be closely coordinated among agencies and preferably handled by a single spokesperson. Following the established procedures of the Incident Command System is often appropriate for large-scale or multijurisdictional outbreak responses.

The effect of training on disaster response: Lessons learned from recent events

2008 ◽  
Vol 6 (5) ◽  
pp. 57
Author(s):  
Hessam M. Afshari, BS ◽  
Paul N. Cervone, MD, LTC ◽  
Mark J. Seaton, PhD ◽  
Miley A. Taylor, BA ◽  
Bruce S. Rudy, DEd
Keyword(s):  
Emergency Preparedness ◽  
Disaster Response ◽  
Training Programs ◽  
Lessons Learned ◽  
Incident Command System ◽  
Incident Command ◽  
Different Response ◽  
Training Exercises

National attention to emergency preparedness has resulted in the development of numerous tabletop and exercise-based training programs for responders. The importance of this type of training with respect to the effectiveness of disaster response, while not in doubt, is difficult to measure. Here, we examined after action reports (AARs) from a variety of disasters in an attempt to determine what, if any, effect training has had on the response to a particular event and on disaster response in general.We also examined AARs and lessons learned from two training exercises. Possibly, the most significant effect of training was the opportunity for people from different response units to interact as a team. Exposure to the Incident Command System was vital to the smooth deployment of assets.

Disaster Preparedness for Clinics – Further Study from Haiti

2020 ◽  
Vol 35 (2) ◽  
pp. 170-173
Author(s):  
Benjamin Kaufman ◽  
Sadia Hussain ◽  
Matthew Riscinti ◽  
Christina Bloem ◽  
Bonnie Arquilla
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Health Resources ◽  
Middle Income ◽  
Incident Command ◽  
Middle Income Countries ◽  
North East ◽  
The North ◽  
And Performance ◽  
Set Up

AbstractObjective:This team created a manual to train clinics in low- and middle-income countries (LMICs) to effectively respond to disasters. This study is a follow-up to a prior study evaluating disaster response. The team returned to previously trained clinics to evaluate retention and performance in a disaster simulation.Background:Local clinics are the first stop for patients when disaster strikes LMICs. They are often under-resourced and under-prepared to respond to patient needs. Further effort is required to prepare these crucial institutions to respond effectively using the Incident Command System (ICS) framework.Methods:Two clinics in the North East Region of Haiti were trained through a disaster manual created to help clinics in LMICs respond effectively to disasters. This study measured the clinic staff’s response to a disaster drill using the ICS and compared the results to prior responses.Results:Using the prior study’s evaluation scale, clinics were evaluated on their ability to set up an ICS. During the mock disaster, staff was evaluated on a three-point scale in 13 different metrics, grading their ability to mitigate, prepare, respond, and recover in a disaster. By this scale, both clinics were effective (36/39; 92%) in responding to a disaster.Conclusion:The clinics retained much prior training, and after repeat training, the clinics improved their disaster response. Future study will evaluate the clinics’ ability to integrate disaster response with country-wide health resources to enable an effective outcome for patients.

scholarly journals The Experience of a Mass Casualty Incident Call in a Tertiary Hospital after the 2018 Hualien Earthquake

2019 ◽  
Vol 34 (s1) ◽  
pp. s131-s131
Author(s):  
Hsing Chia Cheng ◽  
Kuang Yu Niu ◽  
Ming Han Ho
Keyword(s):  
Emergency Department ◽  
Healthcare Providers ◽  
Task Assignment ◽  
Tertiary Hospital ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Incident Command System ◽  
Incident Command ◽  
Efficiency And Effectiveness ◽  
Training Courses

Introduction:After a 6.0 magnitude earthquake struck Hualien on February 6, 2018, over one hundred and fifty patients crammed into the emergency department of a nearby tertiary hospital within two hours. The mass casualty incident (MCI) call was activated, and over 300 related personnel responded to the call and engaged with the MCI management.Aim:This research aimed to analyze the practice of an MCI call and to form the strategies to improve its efficiency and effectiveness.Methods:The research was conducted in a tertiary hospital in Hualien, Taiwan. Questionnaires regarding the practice of the MCI call were sent out to the healthcare providers in the emergency department who responded to that MCI operation.Results:Thirty-seven responders in the emergency department were involved in this study. 78% had participated in training courses for hospital incident command system (HICS) or MCI management before this event. On arrival at the emergency department, 69.4% of the responders were aware of the check-in station and received a clear task assignment and briefing. During the operation, 25.7% reported the lack of confidence carrying out the assigned tasks and 54.1% of the participants experienced great stress (stress score over 7 out of 10).Discussion:MCI is an uncommon event for hospital management. It is universally challenging owing to its unpredictable and time-sensitive nature. Furthermore, the administration could be further complicated by the associated disasters. Despite regular exercises and drills, there are still a significant number of participants experiencing stress and confusion during the operation. The chaotic situation may further compromise the performance of the participants. This study showed that optimizing task briefing and on-site directions may improve the performance of the MCI participants.

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